ABSTRACT-"Triple Jeopardy: Poor and Minority. Early Detection of Breast and Cervix Cancer in Poor and Minority. The elderly, poor and minorities carry the largest cancer burden in the U.S. Substantial reductions in mortality from breast and cervical cancer could be achieved through improved access to, and increased utilization of, early detection services for these groups. The New York City Health and Hospitals Corporation (NYC HHC) is the largest municipal hospital system in the U.S. It serves the majority of older, minority and poor patients in NYC, providing an ideal setting in which to examine cancer control issues in these.high-risk groups. This project has 4 phases: 1) To interview elderly, predominately black women attending Harlem Hospital, one NYC HHC hospital, as they present to the medical clinic for routine care, to determine knowledge, attitudes and health beliefs about early caner detection; 2) To recruit all elderly women coming to Harlem Hospital medical clinic to participate in screening for breast and cervical cancer and to place a nurse practitioner in the clinic to perform same day or future examinations, Pap tests and order mammograms; 3) To audit charts at Harlem Hospital and Queens Hospital (a control NYC HHC hospital) to determine baseline and post-intervention rates of these tests and 4) To integrate the data obtained in all phases to determine which women come for screening and which women do not. The results of this project will be integrated with other cancer research at NYC HHC to inform decisions about the enhancement of early cancer detection programs in the 11 acute care NYC HHC hospitals a.nd their affiliated neighborhood clinics.